Departamento de Métodos Cuantitativos en Economía y Gestión, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.
Departamento de Economía Aplicada y Métodos Cuantitativos, Facultad de Economía, Empresa y Turismo and IUDR, Universidad de La Laguna, Campus de Guajara, 38071 La Laguna, Tenerife, Spain.
Int J Equity Health. 2015 Jan 31;14:9. doi: 10.1186/s12939-015-0132-8.
Adult oral health is predicted by oral health in childhood. Prevention improves oral health in childhood and, consequently in adulthood, so substantial cost savings can be derived from prevention. The burden of oral disease is particularly high for disadvantaged and poor population groups in both developing and developed countries. Therefore, an appropriate and egalitarian access to dental care becomes a desirable objective if children's dental health is to be promoted irrespective of socioeconomic status. The aim of this research is to analyse inequalities in the lack of access to dental care services for children in the Spanish National Health System by socio-economic group over the period 1987-2011.
Pooled data from eight editions of the Spanish National Health Survey for the years 1987-2011, as well as contextual data on state dental programmes are used. Logistic regressions are used to examine the related factors to the probability of not having ever visited the dentist among children between 6 and 14 years old. Our lack of access variable pays particular attention to the socioeconomic level of children's household.
The mean probability of having never been to the dentist falls considerably from 49.5% in 1987 to 8.4% in 2011. Analysis by socioeconomic level indicates that, in 1987, the probability of not having ever gone to the dentist is more than two times higher for children in the unskilled manual social class than for those in the upper non-manual social class (odds ratio 2.35). And this difference is not reduced significantly throughout the period analysed, rather it increases as in 1993 (odds of 2.39) and 2006 (odds of 3.03) to end in 2011 slightly below than in 1987 (odds ratio 1.80).
There has been a reduction in children's lack of access to dentists in Spain over the period 1987-2011. However, this reduction has not corrected the socioeconomic inequalities in children's access to dentists in Spain.
成人的口腔健康状况可由儿童时期的口腔健康状况预测。预防措施可改善儿童时期的口腔健康，进而改善成年后的口腔健康，因此预防可大大节省成本。在发展中国家和发达国家，口腔疾病的负担尤其沉重，弱势群体和贫困人群组受到的影响更大。因此，如果要促进儿童的口腔健康，无论其社会经济地位如何，都应获得适当和平等的牙科保健服务。本研究的目的是分析 1987 年至 2011 年期间，按社会经济群体划分，西班牙国家卫生系统中儿童无法获得牙科保健服务的情况。
本研究使用了 1987 年至 2011 年 8 次西班牙国家健康调查的汇总数据以及国家牙科计划的背景数据。采用逻辑回归分析来检验 6 至 14 岁儿童中从未看过牙医的概率与相关因素的关系。我们对无法获得牙科保健服务的变量特别关注儿童家庭的社会经济水平。
1987 年从未看过牙医的儿童平均概率为 49.5%，而 2011 年下降到 8.4%。按社会经济水平分析表明，1987 年，非熟练体力劳动社会阶层儿童未看过牙医的概率比非体力劳动上层社会阶层儿童高两倍多（优势比 2.35）。而且，在整个分析期间，这种差异并没有明显缩小，而是在 1993 年（优势比 2.39）和 2006 年（优势比 3.03）进一步扩大，最终在 2011 年略低于 1987 年（优势比 1.80）。
1987 年至 2011 年期间，西班牙儿童无法获得牙医服务的情况有所减少。然而，这种减少并没有纠正西班牙儿童获得牙医服务方面的社会经济不平等。
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